A Day in the Life of a Doctor: The Emotional Toll of Dealing with Intransigence
The challenges of a frontline doctor
A Day in the Life of a Doctor: The Emotional Toll of Dealing with Intransigence
Dr. E.V. Rapiti, Cape Town, June 29, 2025
"Don’t be surprised if you momentarily lose your calm composure when confronted by blunt people with the uncanny ability to rattle even the most composed minds. There are simply too many of them to avoid. But don’t allow them to ruin your entire day — vent, debrief, and let it out to get them off your skin and regain your inner calm."
— June 29, 2025
In my forty-two years of working in the low-income area of Mitchells Plain, Cape Town, I have noticed a growing number of rude and intransigent people visiting my practice over the last few years.
Yesterday was one such day. It was a rainy, cold Saturday in Cape Town, and I set out in an extremely buoyant mood, ready to do a good day’s work.
While many doctors either don’t work or slow down on Saturdays, I enjoy working on Saturdays because it is often the only time blue- and white-collar workers can see a doctor specializing in serious issues. The work environment in South Africa has become so tough that many can only attend to their health on their day off.
On Saturdays, I often see patients for the first time with chronic debilitating pain and complex mental health issues—childhood abuse, marital breakdowns, substance abuse, elder abuse, and a wide range of mental illnesses such as depression, anxiety, panic disorder, bipolar disorder, and substance-induced psychosis.
Saturday's is a time when complex problems challenge my experience and mental faculties, which I find most rewarding unlike the mundane work I do on other days of the week.
My first patient was a 57-year-old Hyster driver whom I saw a month ago for severe pain in his right buttock muscle, torn during routine driving. I treated him using a protocol I developed for such conditions, which cannot be effectively managed with the conventional, often toxic, non-steroidal anti-inflammatory drugs routinely prescribed by frontline doctors and orthopaedic surgeons.
This patient, like many before him, had seen several doctors before he consulted me.
He arrived with his wife and daughter. We exchanged pleasantries, talked about the cold weather, and they complimented me on the warm atmosphere of my rooms and the welcoming reception. They said that the environment gave them the feeling that this is a practice that truly cares.
I graciously accepted their compliment and proceeded to assess him. I found that he made a remarkable improvement after my treatment and after following my recommendation to do light work temporarily. I treated the other areas in his buttock and legs and after that he was pain-free.
I explained that torn-muscle-healing takes time—up to three months with rest. Medication and my intervention merely initiate the healing process; the body completes it.
We spent over twenty minutes together—five minutes longer than the usual appointment time—consulting, treating, discussing his condition and the prognosis.
He was concerned that his employer might place him on temporary incapacity leave for three months, resulting in a 25% cut in salary. I understood his worry as he was the sole breadwinner. I advised him to remain on light duty another month in an effort to prevent the salary cut. He and his family were pleased that I was willing to write a motivational letter requesting this extension to continue with light duty for another month and prevent a salary cut.
Incidentally, he mentioned he had an appointment with the state hospital to see a dietician for his diabetes. I immediately did a blood sugar test and found his level to be perfectly normal at 5.3 mmol/L without treatment. I happily informed him he did not have diabetes and provided an easy-to-follow eating plan.
Instead of receiving this good news calmly, his wife erupted into an angry tirade about the state doctors and their services. She insisted on me to explain why the state doctors ordered blood tests.
I saw that she was terribly upset and I tried gently to calm her, advising her not to stress and to be happy that her husband was well. But she continued her relentless and annoying tirade about the hospital .
I realized my time was running short. I intimated to her, as gently as possible, that I had other patients waiting patiently to see me. I told her I could not speak for another doctor’s decisions as that would be unethical and reminded her that I was behind schedule.
She suddenly became upset, accusing me of rushing her and told her husband he should come alone next time, scornfully implying she no longer wished to see me. She stormed out in huff.
What started as a happy congenial consultation, suddenly turned ugly.
The daughter sprang to her mother’s defense, angrily and pejoratively telling me what to do. She insisted that because I was in a hurry she wanted me "to get done."
I explained that I had spent 40 minutes with them, far longer than the average doctor’s less-than-ten-minute consultation. This did not satisfy her, and she too, like her mother, also stormed out, leaving the apologetic father alone. This was a double blow.
This outburst by the two women left me visibly shaken and terribly upset. My calm composure was momentarily shattered.
The gentleman profusely apologized for his wife’s and daughter’s behavior, attributing it to the "strange behavior of women."
My kind patients come to my rescue.
I ended the consultation, expressing my disappointment to him, hoping he would convey my sentiments to his family.
With my years of experience, I quickly recomposed myself before seeing my next patient by using a mental technique of deep breathing to discard one bad experience and not allow it to affect the rest of my day.
I greeted my next patient warmly and cheerfully—a wonderful young lady who commiserated with me. She had overheard the earlier rude outburst and kindly told me not to stress, noting how miserable the other woman seemed.
This reareassurance was comforting. The patient after this patient, a middle-aged social worker, equally nice as the previous patient also greeted me with a big smile and profusely thanked me for treating her back about a few months back. This kind feedback was therapeutic for my rattled mind.
I apologized for the delay and explained the cause. She said she encounters such behavior frequently in her line of work as a social worker. She mentioned that no matter how much you do for people they are never satisfied. She resignedly said it's part of the job. I wondered, should it really be part of our job? We need to let our patients to respect our boundaries.
Suddenly, we shared common experiences of rude people, and I felt reinvigorated to complete my day without allowing the ugly experience to affect the rest of my day.
An elderly lady abused her her daughter
As I was about to finish my day, trying to do a virtual consultation for a patient 2,000 km away, my internet went down. I tried to fix the problem but was forced to call my technician. While waiting for my technician, an elderly 68-year-old lady, walking with a stick and escorted by her son, staggered into the room without an appointment.
She complained of severe pain in her right shoulder, arm, forearm, and thigh on the same side, and wore a sad expression.
She told me about a major altercation that she had with her daughter, who had thrown her out of the house using abusive language. The son informed me that although the house belonged to the mother, the daughter had fraudulently signed papers to take possession of it.
I treated the lady’s pain and counselled her for the abuse that she was subjected to by her daughter. The son told me he would look after his mother, which made me feel a sense of relief.
The lady, I was informed, was going to appear in court against the daughter for fraud. I wrote a letter supporting her case for elder abuse. The old lady felt relieved knowing she had my support should the courts require it.
After closing surgery, my wife and I dashed to an afternoon show at the Baxter Theatre.
On the way, I vented to her about the dreadful experience that had drained me emotionally and mentally. Her listening ear helped ease the tension in my body.
After watching a two-hour mediocre show that made me sleepy, much of the emotional burden dissipated.
I had a good night’s rest. This morning, I reflected on my experiences of yesterday. I decided to write this account of it— it was my way of shedding unwanted, troubling baggage.
Writing my thoughts has always been a great refuge from emotional pain.
I realized I must stop being hard on myself if I lose my composure when confronted by rude, blunt, and intransigent patients or people. Unlike AI, we doctors and healthcare professionals are as human as our patients. We too have feelings.
I understand many patients are under immense stress and turmoil and we have, unwittingly become punching bags for their frustrations and unmet needs. I accept this as part of our work.
What would help is if people learned to apologize for being rude and discourteous when they regain their senses but they seldom do.
This bitter experience will not stop me from treating the gentleman who tried to apologize for his family’s behavior. I have learnt to successfully archive the rubbish and ugly and enjoy the pleasant present.
My message to fellow colleagues is to learn to bounce back from bad experiences by venting, taking time off, and learning how to deal with difficult people if they wish to survive in a world full of volatile and fragile emotions.
We live in a time when people no longer care for each other. Gender-based violence, road rage, homicide, suicide, addiction, divorce, and brutal robberies have become the norm.
I fondly remember my childhood when it was safe to ride in the park or travel in busses late at night without fear of kidnapping, robbery, assault or rape.
The wealthy are guilty of abuse
Today, the wealthy seem indifferent to the suffering of ordinary people. Some, like Bill Gates, openly express dystopian views about reducing the world’s population, and no one challenges it.
Elon Musk, the richest man in the world, pursues a childhood dream of colonizing Mars while billions starve on Earth. A dream he is abandoning because it is so unfeasible and unnecessary.
If the 10% of the wealthy, who own 90% of the world’s wealth, donated half of their fortunes, the entire world could be fed and housed.
This will be possible if the current governments—obsessed with war—are replaced by governments truly "of the people, by the people, and for the people," as was the aim of the French Revolution.
Dr. E.V. Rapiti
Cape Town
June 29, 2025
About the author
Dr Rapiti is a family physician working in the the densely populated suburb of Mitchells Plain, Cape Town for over 42 years, with a keen interest in lifestyle medicine, mental health and addiction. He is an avid reader and writer as well as the author of a self-help book on addiction, "4 Steps 2 Healing" which has helped several of his clients..